| NPI | 1184308140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICKA BROOKE MAZE Counselor 606-748-7244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2025-09-18 |